. 2019 Jul 1;9:55–78. doi: 10.2147/DNND.S208815

Table 4.

Intravenous methylprednisolone (Comparing different doses)

Study/N/Age/Location	Intervention and treatment duration	Summary of efficacy results
Fierro et al (2002)²⁷ N=24 Mean age, years: low-dose group: 31.3; high-dose group: 32.4 Italy	Intervention IVMP 1 g/day (n=9) vs IVMP 2 g/day (n=12) Treatment duration 5 days Assessments Just before (T0) treatment onset and after 7 (T7) and 21 days (T21)	EDSS improvement Baseline EDSS, mean (SD) Low-dose group: 4.0 (1.1) High-dose group: 3.8 (1.1) EDSS scores significantly improved in both groups throughout follow-up period^a T7: ~80% of basal mean EDSS T21: ~70% of basal mean EDSS Wilcoxon’s matched pairs test: High-dose group T0 vs T7: P=0.009 High-dose group T0 vs T21: P=0.01 Low-dose group T0 vs T7: P=0.02 Low-dose group T0 vs T21: P=0.008 ANOVA: High-dose group P=0.0004 Low-dose group P=0.0008
La Mantia et al (1990)³⁰ N=24 Age: NR Italy	Intervention IV dexamethasone (n= NR) vs IVMP high dose (n= NR) vs IVMP low dose (n= NR) Treatment duration NR Assessments Days 7, 14, and 30 following treatment onset as well as 3 and 6 months after treatment onset	EDSS improvement Day 7 after treatment onset: frequency of improvement and extent of recovery was lower in the high-dose IVMP group vs the other groups Day 30 after treatment onset: all patients treated with dexamethasone and high-dose IVMP had recovered; 1/3 patients with low-dose IVMP had recovered
La Mantia et al (1994)²⁹ N=31 Mean age, years: DX: 27.4; HDMP: 31.1; LDMP: 30.1 Italy	Intervention IV dexamethasone (n=11) vs high-dose IVMP (n=10) vs low-dose IVMP (n=10) Treatment duration 14 days Assessments 24 hrs before treatment onset Days 2, 4, 7, and 14 following treatment completion, as well as 1, 2, 4, 6, and 12 months after treatment completion	EDSS score improvement (≥1 point): Day 15: dexamethasone, 10/11 patients; high-dose IVMP, 8/10 patients; low-dose IVMP, 6/10 patients 1 month after treatment completion: dexamethasone, 10/11 patients; high-dose IVMP, 9/10 patients; low-dose IVMP, 4/10 patients
Oliveri et al (1998)²⁸ N=31 Mean age, years: Group H: 27.2; Group L: 31.3 Italy	Intervention IVMP 2 g/day (n= NR) vs IVMP 0.5 g/day (n= NR) Treatment duration 5 days Assessments Baseline (T0) and follow-up days 7 (T7), 15 (T15), 30 (T30), and 60 (T60)	Clinical improvement (EDSS score) achieved during follow-up period in both groups (Friedman’s ANOVA: high dose, P<0.0001; low dose, P<0.0001). Improvement for both groups was significant at T7 and maintained throughout follow-up period: High dose: T0: 3.93 (1.68) T7: 2.90 (1.88) T15: 2.66 (1.78) T30: 2.32 (1.69) T60: 2.25 (1.63) Low dose: T0: 3.5 (1.45) T7: 3.13 (1.52) T15: 2.76 (1.93) T30: 2.46 (2.01) T60: 2.35 (2.09) Intragroup difference before and after treatment: High dose (Wilcoxon’s matched pairs test): T0 vs T7, P=0.005 T0 vs T15, P=0.002 T0 vs T30, P=0.0009 T0 vs T60, P=0.0009 Low dose (Wilcoxon’s matched pairs test): T0 vs T7, P=0.005 T0 vs T15, P=0.002 T0 vs T30, P=0.002 T0 vs T60, P=0.001

Note: ^aEstimated from figure; actual values not reported.

Abbreviations: DX, dexamethasone; EDSS, Expanded Disability Status Scale; HDMP, high dose methylprednisolone; IV, intravenous; IVMP, intravenous methylprednisolone; LDMP, low-dose methylprednisolone; NR, not reported; T0= prior to start of treatment; TX, after X days from baseline.